pp’-DDE农药残留与乳腺癌发病风险的meta分析

目的：研究女性体内有机氯农药pp’-DDE残留与乳腺癌发病风险的关联及关联强度,为女性乳腺癌的预防及治疗提供数据支持。方法：检索中国生物医学文献期刊数据库、中国知网、万方数据库、Pub Med、Web of Science等数据库中从2000年至2015年有关有机氯农药暴露与乳腺癌发病风险的病例对照研究,筛选出符合纳入标准的合格文献,应用Revman 5.0和Stata软件进行分析。结果：共检索获得2 039篇文章,共13篇符合纳入标准。Meta分析结果显示：在血清和脂肪组织中,pp’-DDE平均含量病例组要高于对照组;血清来源的研究pp’-DDE暴露水平与乳腺癌患病风险趋势OR=1.10,95%CI：1.01~1.20,脂肪组织来源的研究pp’-DDE暴露水平与乳腺癌患病风险趋势OR=1.17,95%CI：1.11~1.23;异质性检验P=0.24,I2=24%;亚组分析三个亚组P值均〈0.05,均有统计学意义。结论：有机氯农药pp’-DDE残留可能是乳腺癌的一个危险因素,有效预防和控制有机氯农药的摄入和接触可能有助于减轻患乳腺癌的风险性。

The application of Meta-analysis in the latest comprehensive treatment of breast cancer

Meta-analysis is a kind of systematic review,which uses quantitative method to summarize the results.It is a comprehensive evaluation to the findings of previous studies with higher credibility.Recently,it is applied to all areas of scientific research,particularly in the integrated treatment of breast cancer.Currently,breast cancer is known one of the most common malignant tumors,and its incidence is increasing year by year.Therefore,more and more clinical doctors pay attention to the effect of comprehensive treatment for patients with breast cancer.This article mainly collects the results of comprehensive treatment of breast cancer,in which the method of Meta-analysis is applied.In addition,we discuss the latest progress in order to guide the clinical treatment.

Predictors of neoadjuvant chemotherapy for triple-negative breast cancer:a meta-analysis with 723 cases

Objective: Neoadjuvant chemotherapy (NAC) was increasingly used as a systemic therapy for triple-negative breast cancer (TNBC). The pathological complete response (PCR) rates of neoadjuvant chemotherapy in TNBC were higher than other types of breast cancer with fluctuate data. Predictors to identify which subgroup TNBC was more likely to achieve PCR in neoadjuvant chemotherapy would give us some hints on how to improve outcomes of TNBC patients. The meta-analysis was conducted to contrast the prognostic function of some clinicopathological parameters in the PCR rates of neoadjuvant chemotherapy for TNBC. Methods: Studies were selected from the PubMed database. The relevant parameters to PCR rates in TNBC group were recorded. Review Manager and MIX were used to estimate prognostic function of some biological markers and clinicopathological parameters in PCR rates of TNBC. Results: The analysis included 6 studies with 723 patients, the aggregate PCR rate was 27.9% in TNBC group. The association of lymph nodes metastasis, Ki-67 expression, p53 expression and CK5/6 expression with PCR rate of TNBC was investigated in the analysis, and the odds ratios were 0.50, 9.87, 1.17 and 0.53 respectively. Conclusion: This meta-analysis demonstrated that Ki-67 expression and lymph nodes metastasis were predictors of PCR rate for TNBC in neoadjuvant chemotherapy, while p53 and CK5/6 expression could not be confirmed for the prognostic function.

Neoadjuvant chemotherapy for triple-negative breast cancer:a meta-analysis with 7168 cases

Objective:The pathological complete response(pCR) rates of neoadjuvant chemotherapy(NAC) in triple-negative breast cancer(TNBC) was reported higher than that in non-TNBC but ranged from 12% to 48%. pCR was reported to be a predictor of long overall survival and exact pCR rate of NAC in TNBC would give us some hints on how to improve outcomes of TNBC patients. The meta-analysis was conducted to estimate the pCR rate of NAC for TNBC through contrasting the pCR rates of TNBC and non-TNBC tumors in NAC. Methods: Studies were selected from the PubMed database and Cochrane Collaboration Library. pCR rates were collected in groups of TNBC and non-TNBC tumors. Review Manager 4.2 was used to perform forest plots and funnel plots. Results: The analysis included 22 studies with 7168 patients, the aggregate pCR rate was 29.5% in TNBC group, which was 17.7% higher than non-TNBC. The summary relative risk(RR) for pCR rate of TNBC group with that of non-TNBC group was 2.55. No obvious statistical heterogeneity and publication bias was detected. Conclusion: This meta-analysis demonstrated that NAC showed a higher pCR rate in TNBC than non-TNBC.

P53 gene could be a new effective therapeutic target in triple-negative breast cancer: a Meta-analysis

Objective： The aim of this study was to explore the relationship between p53 gene and triple-negative breast cancer （TNBC）, and determine that whether p53 gene could be a new effective therapeutic target. Methods： We identified studies with quantitative data on the relation of p53 gene and TNBC through searching 12 databases online （Oct. 1999-Oct. 2012） and reviewing the references, which were written in English or Chinese. Summary estimates of odds ratio （OR） was calculated using the fixed-effects model or the random-effects model as appropriate. Results： We identified 12 eligible stud- ies with 1532 cases of TNBC patients and 6329 controls of non-TNBC patients. The test for homogeneity resulted in X^2 = 200.16 （P 〈 0.05）, it showed significant heterogeneity so that a random effect model was applied. Our results showed that the expression of p53 gene could be much stronger in TNBC group than that in non-TNBC group [OR = 2.10, 95% confidence interval （CI） = 1.21-3.65]. In ethnicity-subgroup analysis, we found that in Caucasian group, the expression of p53 gene were stronger in TNBC group （OR = 2.60, 95% CI = 1.21-5.57）, but there was no statistical significance in Asian group （OR = 1.69, 95% CI = 0.83-3.45）. Conclusion： P53 gene could be an effective predictor and a good therapeutic target for TNBC patients in the future, especially in Caucasian. Further researches focusing on p53 gene would gain a breakthrough in the treatment of TNBC.